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Essential elements
for regulation
Bylaw on drug demand reduction
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Working methode for drafting the bylaw
Identify the essential elements for regulation of demand reduction
Which elements are already regulated in Serbian legislation?
Model regulations in Europe Need for regulation through the bylaw
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Topics which need to be regulatedI. General ProvisionsII. PreventionIII. Treatment of addictionIV. Harm reductionV. Rehabilitation and social reintegrationVI. Justice system (prosecution, courts,
prisons..)VII. Sanctions / penalties
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General Provisions 1. Scope of the bylaw:
The aim of the regulation should be:– to prevent and counteract drug addiction, – to establish a legal framework for dealing with
consumers of psychoactive substances, – to establish tasks and prerogatives of relevant
institutions/organisations/entities involved in preventing and counteracting drug addiction,
– to establish sanctions for violating the provisions
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General Provisions 2. Areas to be regulated: Prevention of drug abuse, reduction of the number
of drug users as well as the amount of drugs consumed,
Treatment of drug users and addicts, Reduction of the health and social harm associated
with drug use, Rehabilitation, reintegration of addicted persons
into society.
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General Provisions 3. Guiding principles (I):
Programmes and measures in the field of Demand Reduction should– ensure health and security of individuals and
society,– acknowledge that addiction is a disease which
can and should be treated,– respect Human Rights, in particular guarantee the
right to be treated
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General Provisions 3. Guiding principles (II):
Programmes/measures in the field of demand reduction should– provide help to drug users (treatment,
counselling, rehabilitation, reintegration) in principle on a voluntary basis, notwithstanding other legal regulation,
– constitute a comprehensive, integrated and coherent system of Demand Reduction,
– be easily accessible to all those who need them
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General Provisions 3. Guiding principles (III):
Programmes and measures in the field of Demand Reduction should– comply with the International Drug Control
Conventions of the UN,– be complementary to Supply Reduction
programmes ("Balanced Approach")– be based on (scientific) evidence and on the
relevant standards of conduct,– be systematically monitored.
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General Provisions 4. Relevant institutions/ entities / organisations (I)– Government administration, – Regions, Local Communities, Special drug related
institutions– Educational institutions (Kindergartens, Schools,
Universities, Training institutions) – Health care system– Judicial system (Police, Courts, Prisons)
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General Provisions 4. Relevant institutions/ entities / organisations (II)– Welfare organisations– NGO’s – Civil Society – Media
Responsibilities and competences should be clearly defined within the legal framework
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General Provisions 5. Coordination– All the relevant stakeholders should participate in
planning, organisation and implementation of programmes and measures
– All relevant activities should be coordinated on the local, regional, national level by respective coordinating bodies
– Demand Reduction policy should be matched with Supply Reduction policy ("balanced approach”)
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General Provisions
6. Strategy and Action PlanStrategy and Action Plan should form the basis for measures for counteracting drug addiction
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General Provisions 7. Research– Research in all the sectors of demand reduction is
necessary and must be funded by the State and other institutions
– International cooperation in drug research is essential. Results of research performed in other countries should be taken into account.
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General Provisions
8. Monitoring– National Monitoring Centre is to be established– Records on: consumption, drug related diseases,
treatment, drug related deaths
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Prevention of drug use 1. Forms of prevention
a) Universal prevention (Programmes and measures to avoid that population take drugs)
b) Selective and indicated prevention (Programmes and measures targeting at-risk groups and individuals)
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Prevention of drug use 2. Means of prevention
a) Universal prevention:• educational activities, • health promotion programmes, • informational and awareness raising activities
b) Selective and indicated prevention:• counselling • early intervention• support/assistance
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Prevention of drug use 3. Institutions/organisations responsible for /
dealing with prevention
4. Financing of PreventionFinancing of prevention is needed to ensure the sustainability of prevention activities
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Treatment of addiction Treatment of addiction disease
= scope of the bylaw Treatment of other diseases with narcotics
(e.g. pain) – symptomatic treatment= to be regulated elsewhere
Drug addiction treatment must be integral part of the health and social care system
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Treatment of addiction Range of treatment methods– Detoxification– Medically assisted treatment (substitution
treatment)– Abstinence-oriented treatment – Psycho-social assistance
Any method must comply with the agreed professional standards (state of the art)
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Treatment of addiction
Settings for treatment:– Outpatient – Inpatient (residential) – Outreach work
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Treatment of addiction
Aim of the treatment:– (Gradual) reduction of drug consumption with
the ultimate goal of abstinence – Improvement of the health status and the
quality of life of the addict – Treatment of (psychiatric) co-morbidities
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Treatment of addiction Institutions / organisations / persons providing treatment– Medical doctors / nurses / psychologist / social
workers– Healthcare centres, hospitals, reference centres,
prisons– Social services, offices for youth← Qualification or certification required for institutions and/or professionals
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Treatment of addiction Special provisions for substitution treatment (I)– Special licence for ST required for medical doctors – List of psychoactive substances that are expressively
admitted for ST – Registration • of all medical doctors with substitution licence • and of all cases of substitution treatment (in
anonymised form) in order to avoid double treatment
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Treatment of addiction Special provisions for substitution treatment (II)– Titration of dose and quantities of substitution
substances to be administered– Indications, contraindications and refusal of treatment– Medical treatment should be combined with psycho-
social assistance wherever needed by the patient,– Administrative requirements / control measures
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Treatment of addiction
Financing of Treatment
Financing of treatment is needed to ensure the sustainability of treatment activities
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Harm reduction Definition – Programmes and measures aiming primarily at
reducing the adverse health and social consequences associated with the use of psychoactive substances
– “Aid for survival” (GER)– Must be an integral part of a comprehensive and
coherent continuum of demand reduction measures– Must be complementary to prevention, treatment and
rehabilitation, not replace them
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Harm reduction Types of measures, interventions and services(I): – Low threshold facilities, drop-in centres, shelters,
contact and information units – Medication and emergency kits for management of
overdoses in appropriate places (e.g. naloxone distribution programmes),
– Vaccination programmes (against Hepatitis a.o.),– Voluntary HIV and HCV counselling and testing,– Needle/syringe exchange programmes– Measures to ensure safer use,
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Harm reduction Types of measures, interventions, services (II):
– Services for the management of sexually transmitted infections, particularly to those involved in sex work,
– Diagnostic and treatment of HIV, HCV and TB in injecting drug users
– Well-equipped street-workers and peer outreach workers units,
– Medically supervised outreach facilities (so called “Drug consumption rooms”)
– Violence prevention programmes– Others....
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Harm reduction Types of measures, interventions and services: – Services for the management of sexually transmitted
infections (particularly for sexworkers),– Diagnostic and treatment of HIV, HCV and TB in
injecting drug users – Street-workers and peer outreach workers units,– Medically supervised outreach facilities (so called
“Drug consumption rooms”) – Violence prevention programmes– Others….
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Harm reduction
Integration of harm reduction into public health system and cooperation between e different stakeholders and actors is essential
Financing of harm reduction is needed to ensure the sustainability of harm reduction activities
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Rehabilitation and Social Reintegration Measures aiming at assisting persons using drugs in participating in social interaction, particularly in work life.
Institutions/organisations providing Rehabilitation and Reintegration:• social care institutions and welfare system• unemployment offices• prisons• after-care programmes, therapeutic communities• NGOs• others...
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Rehabilitation and Social Reintegration Cooperation between institutions is absolutely
essential All existing and appropriate programmes and
measures of Rehabilitation and Reintegration should be accessible for drug users
Special programmes and measures for the Rehabilitation and Reintegration of drug users should be established
Sustainable financing is needed
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Justice system
Principle: Treatment instead of prison Rules for preventing and counteracting of drug
addiction within prisons Equal rights for addiction care in and out-side the
prison Reintegration into society after prison
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Essential elements for regulation
Thank you for your attention!